Results of kidney transplantation from suboptimal donors to recipients of the older age group

B. Z. Khubutiya, M. Khubutiya, A. Evseev, A. V. Babkina
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Abstract

Introduction. Among the growing number of patients with chronic renal failure who need dialysis therapy or kidney transplantation, a significant proportion are people over 60 years old, making from 30 to 45% of all patients who need dialysis, according to various sources. The elderly age of the recipient contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation. And the probability of receiving a kidney graft in elderly patients is significantly lower than in young recipients. One of the ways to solve this problem is to use kidneys from suboptimal donors.Material and methods. The analysis of clinical examinations, laboratory and instrumental test results obtained in 124 patients who underwent cadaveric kidney allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including that from suboptimal donors, was carried out. Of these, 69 (55.6%) recipients aged 60 years and older were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) in the comparison group (group 2).Results. Kidney transplantation to elderly patients (aged 60 years and older), including from a suboptimal donor, provides a sufficiently high efficiency with a 1-year recipient survival rate of 98.6% and a functioning graft for 1 year in 75.4% of cases, which does not differ from the survival rate of younger recipients (98.2%), but is inferior by the case rate of keeping the graft functioning (91.9%). Meanwhile, the parameters characterizing the functional state of the transplanted organs that maintained their function for 1 year did not differ statistically significantly between elderly and younger recipients.Conclusions. The results of the study showed that kidney transplantation from suboptimal donors to patients of the older age group provides acceptable results with low mortality of recipients and a 1-year functioning of the graft in 75% of cases. This makes it possible to increase the availability of kidney transplantation for patients of the older age group and achieve better survival results, provided adequate selection of recipients and an objective assessment of the quality of transplanted organs.
从次优供体到老年受者肾移植的结果
介绍。在越来越多的需要透析治疗或肾移植的慢性肾衰竭患者中,很大一部分是60岁以上的人,根据各种来源,占所有需要透析的患者的30%至45%。由于伴随疾病的存在,使移植的近期和长期结果恶化,接受者的老年年龄增加了发生移植物功能障碍的风险。老年患者接受肾移植的概率明显低于年轻患者。解决这个问题的方法之一是使用次优供者的肾脏。材料和方法。对在N.V. Sklifosovsky急救医学研究所接受尸体肾异体移植的124名患者的临床检查、实验室和仪器测试结果进行了分析,其中包括来自不理想供体的患者。其中60岁及以上患者69例(55.6%)为主组(第1组),60岁以下患者55例(44.4%)为对照组(第2组)。老年患者(60岁及以上)的肾移植,包括来自次优供体的肾移植,提供了足够高的效率,1年的受者存活率为98.6%,1年的移植物功能在75.4%的病例中,与年轻受者的存活率(98.2%)没有差异,但在保持移植物功能的病例率(91.9%)方面较差。同时,表征移植器官功能状态的参数在老年和年轻受者之间维持了1年的功能,差异无统计学意义。研究结果表明,将次优供体的肾移植给老年组患者提供了可接受的结果,受者死亡率低,75%的病例1年内移植功能正常。这使得有可能增加老年患者肾移植的可用性,并获得更好的生存结果,只要有足够的受体选择和对移植器官质量的客观评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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